Gliederung

Introduction

Approximately one to three per 1000 children are born with at least moderate, bilateral hearing disorders [Ref.Â 1], [Ref.Â 2]. The neurological development of hearing abilities requires acoustic stimulation in the first 18 months of life. Deficits due to lack of acoustic stimulation within the first two years are not or not easily recovered by later rehabilitation. The consequence is delayed development of speech as well as other cognitive and social functions. Children with connate hearing impairment benefit from early detection and treatment of their hearing loss [Ref.Â 3]. There is no model that explicitly quantifies the effectiveness of universal newborn hearing screening (UNHS) versus other program alternatives in terms of early diagnosis, nor has it been taken into account that diagnosis of hearing impairment within the first few months of life is more "valuable" for further development than diagnosis later in life. Objective: To systematically compare two screening strategies for the early detection of new-born hearing disorders, UNHS and risk factor screening, with no systematic screening regarding their influence on early diagnosis.

Results

UNHS detected 644 QCM up until the age of 6 months (72,2%). RS detected 393 child months (44,1%) and no systematic screening 152 child months (17,0%). UNHS detected 74,3% and 86,7% weighted child months at 12 and 120 months, RS 48,4% and 73,3%, NS 23,7% and 60,6%. At the age of 6 months UNHS identified approximately 75% of all children born with hearing impairment, RS 50% and NS 25%. At the time of screening UNHS marked 10% of screened healthy children for further testing (false positives), RS 2%. UNHS demonstrated higher effectiveness even under a wide range of relevant parameters. The model was insensitive to test parameters within the assumed range but results varied along the prevalence of hearing impairment.

Conclusion

We have shown that UNHS is able to reduce the age at confirmation of hearing loss to a much greater extent as selective RS or NS. Further research should be performed on quality of life and health care utilization due to hearing loss and the proportion of children who follow a regular school and profession career after timely fitting of a hearing aid.